Visual and refractive outcomes of posterior chamber phakic IOL in stable keratoconus

We evaluated the visual and refractive outcomes after phakic visian toric implantable collamer lens (ICL) insertion in stable keratoconus (KC). This retrospective study investigated toric ICL implantation in 14 eyes of 8 patients with stable KC. After 6mo, the mean uncorrected distance visual acuity improved significantly from 0.77 to 0.15 logMAR. The mean best corrected distance visual acuity (BCDVA) improved from 0.18±0.1 to 0.15±0.1 logMAR. Fifty percent of eyes maintained their preoperative BCDVA; 42.8% gained one line. There was no statistical difference in high order or coma aberration. The mean refractive manifest spherical equivalent (MSE), mean refractive manifest spherical error, mean manifest astigmatism decreased significantly postoperatively. At 6mo postoperatively, our achieved mean spherical equivalent was approximately 74%. No intraoperative or postoperative complications occurred. Toric ICL implantation was effective, predictable and safe to correct refractive error and improve visual acuity in patients with stable KC.     

Ankle Evaluation in Active Rheumatoid Arthritis by Ultrasound: A Cross-Sectional Study

Ankle joint evaluation is underestimated in many clinical and sonographic scores used for evaluation and follow-up of rheumatoid arthritis (RA) patients. Agreement on examination parameters is poor among sonographic scores that include the ankle joint. More effort is needed to detect the value of ankle joint examination in RA and assessment of ultrasonographic signs according to frequency, disease duration and activity. The objective of this study was to use ultrasound (US) to detect ankle involvement in active RA and to compare findings with disease duration, disease activity and assessment of ankle bone erosion. A total of 63 RA patients with active disease and 20 controls were included in the study. The tibiotalar and talonavicular joints were examined by US for synovitis and/or effusion in gray-scale and power Doppler modes. The anterior, lateral and posterior ankle tendons were examined for tenosynovitis and tendinosis. Mean age was 35.1?±?8.3 y, mean disease duration was 22.7?±?9.6?mo and the mean 28-joint Disease Activity Score–erythrocyte sedimentation rate was 3.05?±?0.66. Ankle involvement was seen in 28 patients (44.4%). The most frequent pathologies detected were tenosynovitis (30.2%), followed by synovitis (18.3%), erosion (8.7%) and tendinosis (4%). The earliest sonographic signs were tenosynovitis, followed by synovitis, erosion and tendinosis. The right ankle exhibited greater involvement than the left ankle, which was significant with respect to erosions (p?=?0.009). The most common tendon affected by tenosynovitis was the tibialis anterior (22.2%), followed by the tibialis posterior (20.6%). Tenosynovitis, especially of the tibialis anterior and posterior, tibiotalar synovitis and erosions should be considered in future US ankle scores for the assessment of RA.     

The unusual hypertensive patient

Many young patients with systemic hypertension have secondary causes which if identified early could lessen the cardiovascular complications associated with long standing hypertension. Coarctation of the aorta is one of those rare causes. We describe a 40 year old male with hypertension, coarctation of the aorta, bicuspid aortic valve, PDA and an adrenal mass.     

Air pollution effects on the gut microbiota: A link between exposure and inflammatory disease

Global incidence rates for inflammatory bowel disease (IBD) have gradually risen over the past 20 years. Genome-wide association studies (GWAS) have identified over 160 genetic loci associated with IBD; however, inherited factors only account for a partial contribution to the disease risk. We have recently shown that urban airborne particulate matter (PM) ingested via contaminated food can alter gut microbiome and immune function under normal and inflammatory conditions. In this addendum, we will discuss how PM can modify the gut microbial form and function, provide evidence on changes seen in intestinal barrier, and suggest a working hypothesis of how pollutants affect the gastrointestinal tract. The significance of the work presented could lead to identifying airborne pollutants as potential risk factors and thus provide better patient care management.     

Impact of polyurethane on variations in tracheal cuff pressure in critically ill patients: a prospective observational study

Objective  

To determine the impact of polyurethane (PU) on variations in cuff pressure (P _cuff) in intubated critically ill patients.     

Heavy metals and parasitological infection associated with oxidative stress and histopathological alteration in the Clarias gariepinus

Ecotoxicology - The goal of this study was to assess the harmful effects of heavy metal accumulation on Clarias gariepinus (catfish) in two different polluted areas in the Al Sharkia governorate...     

Setting up of teeth in the neutral zone and its effect on speech

Rational goals for denture construction are basically directed at the restoration of esthetics and masticatory function and the healthy preservation of the remaining natural tissues. Little concern has been given to the perfection and optimization of the phonetic quality of denture users. However, insertion of prosthodontic restorations may lead to speech defects. Most such defects are mild but, nevertheless, can be a source of concern to the patient. For the dental practitioner, there are few guidelines for designing a prosthetic restoration with maximum phonetic success. One of these guidelines involves the setting up of teeth within the neutral zone. The aim of this study was to evaluate, subjectively and objectively, the effect on speech of setting up teeth in the neutral zone. Three groups were examined: group I (control) included 10 completely dentulous subjects, group II included 10 completely edentulous patients with conventional dentures, and group III included the same 10 edentulous patients with neutral zone dentures. Subjective assessment included patient satisfaction. Objective assessment included duration taken for recitation of Al-Fateha and acoustic analysis. Subjectively, patients were more satisfied with their neutral zone dentures. Objectively, speech produced with the neutral zone dentures was closer to normal than speech with conventional dentures.     

Complementary Therapies for Fibromyalgia Syndrome – A Rational Approach

During the past decades, worldwide clinical and scientific interest in dry needling (DN) therapy has grown exponentially. Various clinical effects have been credited to dry needling, but rigorous evidence about its potential physiological mechanisms of actions and effects is still lacking. Research identifying these exact mechanisms of dry needling action is sparse and studies performed in an acupuncture setting do not necessarily apply to DN. The studies of potential effects of DN are reviewed in reference to the different aspects involved in the pathophysiology of myofascial triggerpoints: the taut band, local ischemia and hypoxia, peripheral and central sensitization. This article aims to provide the physiotherapist with a greater understanding of the contemporary data available: what effects could be attributed to dry needling and what are their potential underlying mechanisms of action, and also indicate some directions at which future research could be aimed to fill current voids.